Elbeuf

Researchers are evaluating different antimicrobial therapies for infections caused by difficult-to-treat Pseudomonas aeruginosa, a type of bacteria resistant to many common antibiotics. This study focuses on comparing new beta-lactambeta-lactamase inhibitor combinations, cefiderocol, and older treatments like aminoglycosides and colistin to understand their effectiveness in real-life settings for patients facing these challenging infections. The study is a prospective, multicenter cohort involving patients who require intravenous antibiotic treatment for their P. aeruginosa infections. Participating patients will receive one of the available antimicrobial options, and their bacterial samples will be analyzed centrally to assess susceptibility and resistance mechanisms. The study collects clinical data throughout treatment and monitors outcomes such as cure rates, resistance development, adverse events, and mortality. Participants will be followed until hospital discharge and up to 28 days after treatment completion. Researchers will track clinical cures, microbiological eradication, adverse events, emergence of resistance, and acquisition of other multidrug-resistant bacteria. Data collection includes electronic case reports and laboratory testing on bacterial isolates. The total participation duration varies according to hospital stay and follow-up schedules, with rigorous monitoring of safety and treatment outcomes.

Each year, in France, more than 2.000.000 patients visit for a acute cystitis. The literature shows that acute cystitis without risk of complication cause pyelonephritis only on really rare situation, but french delegation protocols to pharmacist ask for systematic antibiotic therapy as soon as the diagnostic is made with the only goal to lowering symptomatology. Studies shows that some informed women would like not to take antibiotics while others studies show us that pain-killers could be as effective as antibiotics on case of low symptomatology. This study will compare a group following only the French protocols for delegating acute cystitis to the pharmacist with a group using the same protocol, but supplementing it with a shared decision-making tool to determine whether, after being informed of the benefits and risks of this treatment, patients still wish to receive an antibiotic. Targeting instead of systematic prescription will reduce antibiotic consumption. After diagnostic of acute cystitis to a woman between 18 and 65 years, investigators check if they filing all study criteria and ask for authorization to add them to the study. Then they'll act following their group instruction, and get informations (antibiotic prescription or not, patient socio-demographic criteria). Then patients will be followed by telephone on D14 to know if they've take antibiotics and to obtain the following information: AIA scale, O'Connor Scale, Satisfaction scale, if there has been visit to the emergency room or doctor. Antibiotics delivery on pharmacy will be watch by National assurance number of the included patients

Gout is a common inflammatory condition caused by high levels of uric acid leading to painful joint attacks and potentially chronic joint damage, kidney failure, and cardiovascular problems. This trial investigates whether starting febuxostat, a urate-lowering medication, immediately after an acute gout attack is as safe and effective as the current practice of delaying treatment by six weeks. The study aims to better understand if early treatment can prevent worsening of gout and its complications without increasing early relapses. Participants are randomly assigned to one of two groups one begins febuxostat treatment immediately at 80 mg daily for 12 weeks, and the other starts febuxostat only after a six-week delay. The study includes an initial 6-week comparison period, followed by an extension phase where all participants receive febuxostat, and a final evaluation at six months to assess ongoing treatment effects. Febuxostat is chosen for its potency and suitability for patients with moderate kidney issues. Throughout the study, participants will report daily gout symptoms and pain levels using a diary and visual scales. Physical and joint examinations, blood tests to monitor uric acid and inflammation, and assessments of physical function will occur at 2, 6, 12, and 26 weeks. Researchers will track the number of days with gout attacks, treatment tolerance, and overall patient well-being to compare early versus delayed febuxostat use. The study is conducted with blinded evaluators to ensure unbiased results.

Researchers are evaluating the long-term electrical, echocardiographic, and clinical outcomes of conduction system pacing CSP, which includes His Bundle Pacing or Left Bundle Branch Area Pacing. This observational study addresses the limited data currently available on the long-term results and benefits of CSP, especially focusing on the maintenance of physiological ventricular activation and conduction system capture over time. The study aims to provide reliable data on the preservation of CSP during a two-year follow-up period. Participants who have undergone a conduction system pacing attempt will be followed prospectively. Electrical data such as pacing thresholds, impedance, and R wave sensing will be collected during routine pacemaker check-ups to assess threshold stability. Echocardiographic evaluations will monitor changes in left ventricular ejection fraction LVEF and ventricular synchrony. Clinical data including the incidence of atrial fibrillation, heart failure hospitalizations, and NYHA stage will also be gathered to provide a comprehensive view of patient outcomes. Participants will undergo systematic follow-up visits over 24 months to record electrical parameters, heart function via echocardiography, and clinical status. The main outcome measured is freedom from major adverse events at 24 months. Secondary measures include LVEF, atrial fibrillation incidence, heart failure hospitalizations, conduction system pacing thresholds, paced QRS width, and ventricular dyssynchrony parameters. This long-term observation will help clarify the benefits and stability of CSP in a real-world setting.

Researchers are studying patients who have lived for three years or more after being diagnosed with metastatic lung cancer and who are no longer receiving cytotoxic chemotherapy. The study aims to understand these patients clinical characteristics, health status, socioeconomic impacts, quality of life, and their ability to return to work. This observational research focuses on both non-small cell lung cancer NSCLC and small cell lung cancer SCLC. Participants will be observed over time without receiving experimental treatments. They will complete several questionnaires related to quality of life, anxiety, and depression at the start of the study, then at 6 and 12 months, and annually for up to five years. Their health and treatment history, including any ongoing therapies like immunotherapy or targeted therapy, will be recorded throughout the study. During the study, participants will continue their usual medical care and attend regular consultations as needed. Researchers will collect data through questionnaires and health evaluations to measure clinical characteristics, health status, socioeconomic factors, and psychological well-being. The main outcomes include baseline clinical data and repeated assessments over five years to better understand long-term survivorship after metastatic lung cancer diagnosis.

Researchers are collecting real-life data on patients aged 70 years and older who are receiving first-line treatment for thoracic tumors, specifically Non-Small-Cell Lung Carcinoma, following standards defined by the European Society for Medical Oncology. The study aims to characterize participants geriatric health, biology, and cancer features, as well as to describe treatment methods and assess outcomes such as efficacy, safety, and quality of life. Exploratory subgroups treated with the same drug or innovative strategies will also be identified. Participants will undergo systemic treatment for their lung cancer according to current standard care or innovative therapies. Blood samples will be collected before the first treatment for biobanking, and tumor samples will be sent for central analysis. Patients will attend clinic visits as per usual care and will complete three quality of life questionnaires during the study. Throughout the study, participants will have regular visits and tests to monitor their general condition and treatment effects. This includes lab tests, imaging, re-biopsies, and assessments tailored for older adults. Quality of life is measured at several time points using validated questionnaires. The main outcome being tracked is progression-free survival up to two years, along with other outcomes like response rates, overall survival, safety events, and geriatric interventions. Participants may be followed for up to two years in total.

Colorectal cancer mostly affects elderly patients, with over half diagnosed at age 70 or older in France. This research evaluates the benefit of adjuvant chemotherapy after surgical removal of stage III colon cancer in elderly patients, focusing on whether fluoropyrimidine-based or oxaliplatin-based chemotherapy improves disease-free survival. The study addresses concerns about the effectiveness of chemotherapy in very elderly or unfit patients and includes an assessment of tumor biological factors common in the elderly. Participants are divided into two groups based on a doctors evaluation involving a geriatrician, with different randomization assignments. Treatments being studied include chemotherapy regimens with LV5FU2 or capecitabine and FOLFOX4 or XELOX, as well as observation. The chemotherapy is started within 12 weeks after surgery. The study compares these approaches to determine the best adjuvant chemotherapy strategy for elderly patients. During the study, participants undergo assessments including geriatric questionnaires and monitoring of toxicities. Researchers measure disease-free survival three years after the last patient joins, along with overall survival at five years. Safety is evaluated by observing side effects graded by standard criteria. The study excludes patients with less than four years expected survival and ensures medical follow-up is possible. Participation duration and detailed monitoring support evaluating chemotherapy benefits in this population.

This research aims to screen people who use drugs for hepatitis B, hepatitis C, and AIDS viruses. It focuses on identifying active infections using a simple blood collection method. The study is sponsored by the University Hospital, Rouen, and does not involve experimental drug treatments but diagnostic testing. Participants will have their blood collected using a Dried Blood Spot method, which is a minimally invasive way to collect samples. The study includes individuals who are former or current intravenous or nasal drug users, as well as those on opiate substitution therapy. The screening occurs at the start of participation to detect active infections. Participants will be assessed on the first day for active hepatitis B, hepatitis C, and AIDS infections. The main measurements are the number of individuals found to have active infections of these viruses. This study does not involve any treatment and focuses on diagnostic testing and data collection during the initial visit.